Abd El-Latif Marwa, Azzam Hanan, Othman Maha, Warda Osama, El-Sharawy Solafa, Ghoneim Hayam
Students' Hospital, Faculty of Medicine, Mansoura University, Egypt.
Clinical Pathology Department, Faculty of Medicine, Mansoura University, Egypt.
Pregnancy Hypertens. 2017 Apr;8:65-69. doi: 10.1016/j.preghy.2017.03.006. Epub 2017 Mar 27.
Deficient anticoagulant activity of annexin A5 and deficient profibrinolytic activity of annexin A2 have been linked to increased risk of thrombotic events. Placental dysfunction due to fibrin deposition/microthrombi has been implicated in the pathogenesis of pre-eclampsia (PE). In this study, we aimed to assess serum levels of annexin A5 and annexin A2 in a cohort of PE patients and investigate their role as biomarkers for the development of the disease. We examined 80 women in total; 40 healthy pregnant women and 40 pregnant women with PE after 20weeks of pregnancy. Women were subjected to full clinical assessment, ultrasonography, and laboratory testing including complete blood picture, liver and kidney function tests and assessment of serum and urine proteins. Annexin A5 and annexin A2 were analyzed using enzyme-linked immunosorbent assay. The study showed serum annexin A2 but not annexin A5 was significantly reduced (P=0.029) in women with PE (total and severe cases) compared to those with normal pregnancy. The ROC analysis of annexin A2 level for the prediction of development of PE showed an area under the curve of 0.64 (P=0.029), and the best cut-off value was 0.89ng/ml with a sensitivity of 70.0% and a specificity of 70.0%. Univariate analysis showed annexin A2 of <0.89ng/ml, proteinuria, lower platelet count and higher BP were associated with significantly higher risk to develop PE. Based on this pilot study, serum annexin A2 levels may be a useful biomarker for pre-eclampsia. However, a larger study is required before a final conclusion is made.
膜联蛋白A5抗凝活性不足以及膜联蛋白A2纤溶酶原激活活性不足与血栓形成事件风险增加有关。由纤维蛋白沉积/微血栓引起的胎盘功能障碍与子痫前期（PE）的发病机制有关。在本研究中，我们旨在评估一组PE患者血清中膜联蛋白A5和膜联蛋白A2的水平，并研究它们作为该疾病发展生物标志物的作用。我们共检查了80名女性；40名健康孕妇和40名妊娠20周后患有PE的孕妇。对这些女性进行了全面的临床评估、超声检查和实验室检测，包括全血细胞计数、肝肾功能检查以及血清和尿液蛋白评估。使用酶联免疫吸附测定法分析膜联蛋白A5和膜联蛋白A2。研究表明，与正常妊娠女性相比，患有PE（包括全部和重度病例）的女性血清膜联蛋白A2显著降低（P = 0.029），但膜联蛋白A5未降低。对膜联蛋白A2水平预测PE发展的ROC分析显示曲线下面积为0.64（P = 0.029），最佳截断值为0.89ng/ml，灵敏度为70.0%，特异性为70.0%。单因素分析表明，膜联蛋白A2<0.89ng/ml、蛋白尿、血小板计数较低和血压较高与发生PE的风险显著升高相关。基于这项初步研究，血清膜联蛋白A2水平可能是子痫前期的一个有用生物标志物。然而，在得出最终结论之前还需要进行更大规模的研究。
